Basic Information
| Provider Information | |||||||||
| NPI: | 1902995038 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLINS | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13020 PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | SEMINOLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337763639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273933404 | ||||||||
| FaxNumber: | 7273941804 | ||||||||
| Practice Location | |||||||||
| Address1: | 3800 E BAY DR | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337711937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273933404 | ||||||||
| FaxNumber: | 7273934814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 12/27/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | OS9891 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.